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SBA 1995-300CASE NO: CITY OF'LA QUINTA FEE: $.100.00 PLANNING & DEVELOPMENT DEPARTMENT APPLICATION FOR SETBACK ADJUSTMENT APPLICANT: Submit •this form with two copies ,of a scaled site plan, drawn to adequately depict the nature of the request.. A nonrefundable fee of $100 is required when the Application is submitted. Check must be make payable to the "City of La Quinta". If the Applicant is not the owner of the property, a letter must be submitted by the owner authorizing the Applicant -to execute this document in his -behalf. ************************************************************************** PLEASE PRINT OR.TYPE APPLICANT/CONTRACTOR:�Q� A"b <S4-0 DATE 3-�3 CONTACT PERSON (IF DIFFERENT) PHONE 3'0'QOOO MAILING ADDRESS: yjy 1f&W Ak_Ec 115> ykel afffvL 17221 (Address) (City) (State) (Zip OWNER'S,NAME:' PHONE MAILING ADDRESS: Address) STREET ADDRESS OF PROPERTY: LEGAL DESCRIPTION OF PROPERTY: ASSESSOR'S PARCEL.NUMBER: ADJUSTMENT REQUESTED: REASON FOR REQUEST: City LOT # 34 State) (Zip) 04� JUSTIFICATION: No request for a Setback Adjustment shall be granted unless it is determined that it is consistent with the intend and purpose of this Ordinance; that there are special circumstances applicable to the property, including•such factors as size, shape, topography, location or surroundings. that justify the approval of the adjustment of the 'setback requirement, and that the adjustment will not be detrimental to the health, safety, and general welfare of the community or be detrimental to property in the'area of the parcel for which the adjustment is requested.' ************************************************************************** FORM.013/CS MEMORANDUM CASE: Location(s) Request(s): 6,3 2.1 S se-i 3 Your setback adjustment application is hereby approved, subject to the following conditions: conditions: 1. Obtain a building permit from the Building and Safety Department.. 2. The other Zoning Code provisions shall be met.; 3. If ground excavation is required, please contact Underground Service Alert',(USA) at 1-800-422-4133.. The service is free of charge provided USA is given at least two working days' notice. , 4. Additional Conditions: After review it was determined that: 1. This adjustment is consistent with the intent and purpose of the Zoning Ordinance. 2. There are special circumstances applicable to the property, including such factors as size, shape, topography, location or surroundings that justify approval of the adjustment. These circumstances are: -5� & y A Thank you forryour cooperation. 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